Sebahattin DESTEK, Vahit Onur GÜL, Yersu KAPRAN, Emre BALIK, Dursun BUĞRA, Ali AKYÜZ

Mide Kanseri Gelişiminde Duodenogastrik Reflünün Rolü: Siklooksijenaz-2 İnhibitörlerinin ve Balın Önleyici Etkilerinin Deneysel Olarak Araştırılması

Amaç: Gastroenterostomi deneysel modeli ile duodenogastrik reflü oluşturulan sıçanlarda mide mukozasında metaplazi, displazi ve adenokarsinom döngüsünün siklooksijenaz-2 (COX-2) inhibitörü ve polifloral bal ile ne düzeyde engellendiğini histopatolojik ve immünohistokimyasal parametrelerle karşılaştırmalı olarak araştırmayı amaçladık. Gereç ve Yöntem: Çalışma kontrol grubu, COX-2 grubu ve bal grubu olmak üzere toplam 3 grupa ayrılarak gerçekleştirildi. Her bir deneğe gastrojejunostomi deneysel modeli yapıldı. Kontrol grubuna sadece standart rat yemi ve musluk suyu içirildi. COX-2 grubuna orogastrik yolla 5 mg/kg/gün meloksikam verildi. Bal grubuna orogastrik yolla 5 ml/kg/gün polifloral bal yedirildi. Her üç gruptaki ratlar ameliyattan 40 hafta sonra yüksek doz dietil eter inhalasyonu ile sakrifiye edildiler. Deneklerin mide ve anastomoz bölgesi mukozaları hemotoksilen-eozin (H-E) boyaması ile histopatolojik olarak ve COX-2 protein antikorları ve p53 protein antikorları ile immünohistokimyasal olarak incelendi. Bulgular: Histopatolojik ve immünohistokimyasal inceleme sonrasında kontrol grubunda 3 denekte (%30) anastomoz bölgesinde adenokarsinom geliştiği saptandı. COX grubunda 2 denekte (%22) anastomoz bölgesinde adenokarsinom geliştiği saptandı. Bal grubunda hiçbir denekte adenokarsinom gelişmedi. Bu verilere karşın, gruplar arasında anlamlı bir istatistiksel farklılık elde edilemedi. Sonuç: Duodenogastrik reflü içerdiği safra ve pankreas ekzokrin salgısı ile midede karsinojen etki göstermektedir. Deneysel çalışmamızın sonucuna göre polifloral bal bu karsinojen etkiyi ve kanser oluşumunu, selektif COX-2 inhibitörlerine göre daha güçlü bir şekilde engellemektedir.

The Role of Duodenogastric Reflux in Development of Gastric Cancer: An Experimental Research of the Preventive Effects of Cyclooxygenase-2 Inhibitors and Honey

Objective: The aim of this experimental study was to evaluate the preventive effects of cyclooxgenase-2 (COX-2) inhibitors and polifloral honey on the gastric carcinogenesis in a duodenogastric reflux model. Material and Method: Thirty-six rats were enrolled in the study and simple gastrojejunostomy was performed in all the animals. The rats were separated in three equal groups with 12 animals each. In the first group (control) only standard rat food and tap water were given. Additionnally, 5mg/kg/day meloxicam and 5 ml/kg/day polifloral honey were given in the second (COX-2) and third (honey) groups respectively. Forty weeks after the operation, all rats were sacrified with high dose diethyl ether inhalation. The mucosa of the anastomotic region and stomach was evaluated in light microscope with hematoxylene-eosin, and also immunohistochemistry was done with p53 and COX-2 antibodies. Results: In control and COX-2 groups gastric adenocarcinoma was found in 3 (30%) and 2 (22%) animals respectively. In the polifloral honey group no adenocarcinoma was revealed. Despite these findings, a statistically significant difference was not found between the groups due to a small sample size. Conclusion: The exocrine pancreatic secretion and bile induces a carcinogenic effect on the gastric mucosa in an experimental duodenogastric reflux model. In the present study we can conclude that the protective effect of polifloral honey is much more pronounced than the effect of COX-2 inhibitors

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